Blog Post

70% of physicians still prefer fee-for-service—here are 3 ways to win their buy-in on value-based care

August 7, 2018

    Editor's Note: This blog is a rebroadcast of How to get physicians on board with your accountable care goals—in 3 steps, originally posted by Alicia Daugherty and Dhananjai Seth. This rebroadcast is tailored for population health leaders.

    Physician buy-in is critical to succeed under value-based care arrangements. However, many physicians doubt that their organization is prepared to shift to value-based care, and half of physicians actually believe that capitation reduces quality.

    Because doctors influence up to 85% of all quality and cost decisions, physician buy-in for value-based care is essential. And while a recent report by Bain and Company shows that physicians understand the challenges of delivering quality care with rising costs, they still want evidence that an overhaul in reimbursement and management structure will actually achieve this goal. 

    3 ways to win physician buy-in

    One effective way to gain physician buy-in is to include them in decision-making. Not only is their input critical to advancing clinical care, but physicians involved in strategy development also tend to be more satisfied with their work environment and more willing to lead change. However, since not every physician can take part in the planning process, here are three scalable tactics to get physicians engaged in your strategic objectives:

    1. Build trust in strategic efforts

      Research shows a 40% increase in physician adherence when providers share performance data with doctors. However, even with transparent data sharing, you must build in flexibility to respond to feedback. Anticipate pushback on error attribution, data recording, results interpretation, and data selection—and build trust by preempting these concerns with transparency. For example, Montefiore Medical Center standardizes and centralizes data collection, and organizes regular meetings where physicians can voice concerns about metrics.

    2. Provide consistent feedback on performance toward goals

      Don't just provide consistent and continuous feedback to the outliers: talk to your average performers, as well. Targeting outlier physicians can achieve near-term progress, but this approach provides limited and diminishing results as outliers are eliminated. In comparison, by communicating with average performers, providers can achieve gradual behavior change from many physicians. And while this strategy requires a greater investment in time and effort, it provides greater return over time.

    3. Develop aligned incentive structures

      Consider designing alignment models that tie financial incentives to physicians' support of new goals. This approach is especially important given delayed rewards of shared-savings arrangements. Transparency of included metrics is key. In the specific case of reducing care variation, for example, providers can tie payment to metrics related to care standard adherence. Providers could also consider rewarding physicians for time spent on care standard design teams.

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